Impact of magnetic resonance imaging on cardiac mortality in thalassemia major

Purpose: To evaluate whether the introduction of magnetic resonance imaging (MRI) in the management of thalassemia major (TM) patients has affected the risk of cardiac death. Materials and Methods: In all, 804 TM patients from two large reference units were included and the risk of dying of cardiac causes, before and after their first MRI, was assessed by a Cox proportional hazards model with time-dependent covariates. Results: Adding information from MRI reduced the risk of cardiac death from 6.0 deaths/1000 patient-years to 3.9 deaths/1000 patient-years (P = 0.22). The risk of cardiac death before having an MRI study was 82% higher compared to the risk observed after the first MRI. Conclusion: MRI has become a vital component of ongoing management and seems to have a beneficial effect on cardiac mortality in TM. © 2011 Wiley-Liss, Inc.